Disability: The Understudied Population in Orthopaedics.

Area of Science:

• Orthopaedic Surgery
• Public Health
• Health Disparities Research

Background:

• Healthcare disparities significantly impact healthcare delivery.
• Patients with disabilities are an under-recognized population requiring focused public health attention.
• Existing literature often overlooks disability as a factor in healthcare access and outcomes.

Purpose of the Study:

• To systematically review and characterize published literature on access to and outcomes of orthopaedic care for people with disabilities.
• To identify gaps in the current research regarding disability and orthopaedic care disparities.
• To inform future research directions for promoting equitable orthopaedic care.

Main Methods:

• Systematic review of articles published in the last five years from top 20 impact factor, Medline-indexed American orthopaedic surgery journals.
• Literature search conducted using PubMed.
• Inclusion criteria focused on studies assessing access or outcomes of orthopaedic care among underserved populations, with data extraction by two independent reviewers.

Main Results:

• 124 manuscripts met inclusion criteria; 49.2% focused on access disparities, 29.0% on outcomes disparities, and 21.8% on both.
• Commonly studied disparity factors included race, insurance status, socioeconomic status, ethnicity, and chronic illnesses.
• Only 5.0% of studies examined barriers related to disability, indicating a critical research gap.

Conclusions:

• A significant gap exists in orthopaedic literature concerning access to care and outcome disparities for patients with disabilities.
• Disability-related barriers are examined less frequently than those for other underserved populations.
• Future research must systematically evaluate barriers faced by people with disabilities and promote inclusive design for equitable orthopaedic care.